This Midcareer Investigator Award in Patient-Oriented Research application focuses on training and mentoring of cardiovascular imaging techniques (i.e., echocardiography, cardiac MRI, and positron emission tomography) for the study of mechanisms of disease in patients with cardiovascular diseases. The goals are: 1) to continue the mentoring program of cardiology fellows established by the applicant, 2) to continue patient-oriented research in the applicant's laboratory, and 3) for the applicant to acquire additional training and skills in cardiac MRI. The applicant-PI has an established record of mentoring young investigators, and will use this grant as a mechanism to further mentoring of young investigators, and will use this grant as a mechanism to further the mentoring of young investigators in the use of non-invasive cardiovascular imaging techniques to answer clinically relevant questions through hypothesis-testing. Young trainees will be exposed to ongoing clinical investigations that use novel methods and techniques to explore mechanisms of human disease in a multi-disciplinary environment. The main themes of investigation of the applicant include elucidation of the relationship between myocardial blood flow, contractile function and metabolic function in various disease states such as hypertensive heart disease and heart failure. The applicant will continue to develop a clinical research program that builds upon recent developments in this area by our group and others. This multi- disciplinary approach to elucidate mechanisms of human disease in clinical medicine include the use of clinical and quantitative tools for hypothesis testing. Trainee support is obtained through several mechanisms: The Cardiovascular Division's NIH Training Grant, the NIH's Minority Investigator Research Supplements, the AHA, and private foundations (Fourjay, Dana, Doris Duke, and Robert Wood Johnson). Trainees will formulate hypothesis that require quantitative characterization of cardiovascular pathophysiology through the acquisition and processing of multi-imaging data, and test them through the use and application of biostatistical methods. The ultimate goal of the PI is to expand the training program of cardi9logy fellows that want o become independent clinician-scientists. A funded research program that illustrates the research program for young investigators is described, to illustrate the applicant's involvement in mentoring in patient-oriented research.